Keene, Matthew S.

Keene, Matthew S. is an sole proprietor health care provider with primary practice located at 4777 East State Street Suite 8, Rockford IL 61108. He recently has 3 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Keene, Matthew S. can be contacted via phone (815) 980-8980.

Contact Information

Primary practice address
4777 East State Street Suite 8 Rockford IL 61108
Phone: (815) 980-8980
Fax: (815) 397-2266
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 016005216 Illinois
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X 016005216 Illinois
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 016005216 Illinois

Profile Details

NPI number 1508967621
LBN Legal business name Keene, Matthew S.
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 25th, 2006
Last updated Sep 12th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508967621 NPPES
Illinois Other 010132351 ILLINOIS BLUE CROSS
Illinois MEDICAID 016005216 ILLINOIS BLUE CROSS

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